BCI results in a spectrum of outcomes from asymptomatic to sudden cardiac death
Normal screening ECG is associated with a 98% negative predictive value
Sinus tachycardia is the most common ECG abnormality among trauma victims
Myocardial contusion (MC) is the most common & ambiguous diagnosis following BCI
MC has no consensus definition or uniform diagnostic criteria and can be loosely defined as BCI w/mild increase in cardiac biomarkers or frank cardiac dysfunction (e.g. wall motion abnormalities, arrhythmias, conduction disturbances, or SCD)
BCI w/ a normal ECG & stable hemodynamics have a benign clinical course and rarely require further diagnostic testing or long periods of close observation
Individuals w/ECG abnormalities, hemodynamic instability, or rapid deceleration injury concerning for blunt aortic injury (BAI) warrant imaging of heart and great vessels by echocardiogram and CT scan
References
Bock J, Benitez M. Blunt Cardiac Injury. Cardiology Clinics. 2012;30(4):545-55.
